Improving the Lifestyle of Adolescents Through Peer Education and Support in Vietnam: Protocol for a Pilot Cluster Randomized Controlled Trial (Preprint)

Abstract

BACKGROUND In Ho Chi Minh City (HCMC), Vietnam, recent studies found a rapid increase in overweight and obesity in adolescents. There is a need for effective health promotion interventions to support healthy diets and encourage a physically active lifestyle. This study will help fill an evidence gap about effective interventions to prevent excess weight gain in adolescents and generate new insights about peer-led education to promote healthy lifestyles. OBJECTIVE We aim to assess feasibility and acceptability of a combined peer-led and peer-support intervention among junior high school students in HCMC. Additionally, efficacy of the intervention on adolescents’ dietary practices and time spent on physical activity will also be measured in this pilot study. METHODS Peer-Education and Peer-Support (PEPS) project is a pilot randomized controlled trial with two intervention and two control schools. The intervention consists of four weekly education sessions of why and how to choose healthily food and drinks, and how to be more physically active. Additionally, the intervention includes a school and online support system to help maintain engagement of the students in the intervention. We will use in-depth interviews with with the students, peer leaders, teachers and parents, focus group discussions with peer educators, and direct observation of school environment and peer leaders’ interactions with the students. Acceptability and feasibility of the intervention will be assessed. We will also quantitatively assess limited efficacy by measuring changes in physical activity and dietary behaviors of the students. RESULTS Date of first participant enrolment was early September 2018 and recruitment completed by March 2019. Totally 317 Grade 6 students were recruited. We delivered the peer education intervention at the start of each school year over 3 months for all new Grade 6 adolescents in the allocated schools, followed by peer support and home engagement activities over 6 months till the end of the school year. There was a baseline assessment and two post-intervention assessments: the first immediately after the intervention to assess the short-term impact; and the second at the end of the school year to assess the sustained impact on the change in adiposity indicators and diet and physical activity. Recruitment of participants in this pilot study include recruitment of peer-educators (undergraduate students of Pham Ngoc Thach University of Medicine) (PNTUM), peer-leaders (Grade 8 students) and target Grade 6 students. CONCLUSIONS The findings of this study will be used to develop a larger-scale cluster randomized controlled trial to examine the impact of a multi-component, school and home-based health promotion intervention using innovative peer education methods on reduction of overweight and obesity, and improvement of diet and physical activity in Vietnamese adolescents. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR), identifier: ACTRN12619000421134. Retrospectively registered on 14 March 2019.